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Old 09-26-2008, 07:44 AM   #1
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itotito HB User
Question for insulin users

The time of day I struggle the most is morning. Many weeks, I will be around 117 first thing in the morning. However for the last 3 weeks I have been at 90 every morning. But I'd say more often I am between 110 and 125.

Nights I am pretty good and until now my 1ac has been low 5 through diet and excercise.

So here's my idea: I am wondering if I should try insulin injections at night that would getting me better morning fasting levels.

My problem would be that I am not consistent in my levels. I go 2 months at 120 then 3 weeks at 90. Never over 130. How do I make sure I wouldn't go hypo ?

Is there such thing as insulin you inject at 10pm that works at 6AM ?
Do some people only inject for the morning ? My fasting before dinner is 80ish, my PP after dinner are 108ish....so I doubt I would do this any other time.

Is this a crazy idea ? I plan to talk with my doc this afternoon but sometimes I think some of the insulin users here know more about diabetes than he does :-)

PS : I know my morning highs are not rebounds. I am pretty sure there are liver dumps/morning hormone related.

 
Old 09-26-2008, 12:59 PM   #2
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SamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB User
Re: Question for insulin users

I don't know, Itotito, but here are some of my thoughts.

First, if your 2-hour PP after dinner is as low as 108, you might be going low overnight. Are you checking right before bedtime? This is the first thing I'd do...if your bedtime numbers are down around 80-90, you might be experiencing lows overnight, which means you'd need a small bedtime snack.

But, if your bedtime numbers are not too low, it's possible that you are having Dawn Phenomenon. The only way to test this, unfortunately, is to wake up several times at 3:00 AM, 4:00 AM and possible 4:30-5:00 AM and test. If your numbers at those times are reasonably normal, but not too low (not below 70), then it is Dawn Phenomenon. In that case, it's possible that some NPH insulin at bedtime, which peaks about 4-6 hours after you take it, could lower those morning numbers or, you could take a unit or two of rapid-acting insulin upon awakening. On the other hand, if you test at those hours and your numbers are below 70, then possibly you might actually need a bedtime snack.

I'm going through the same thing myself...all of a sudden, for the past several weeks, my morning numbers have been getting higher and higher. Unfortunately, I take sleep medication, so getting up to test in the wee hours hasn't been successful yet...but I will keep trying. I'm pretty certain it's Dawn Phenom, but then I did have one morning when I woke up at 95...just to confuse the issue, I guess!

Ruth

 
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Old 09-26-2008, 01:51 PM   #3
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Re: Question for insulin users

Quote:
Originally Posted by SamQKitty View Post
I don't know, Itotito, but here are some of my thoughts.

First, if your 2-hour PP after dinner is as low as 108, you might be going low overnight. Are you checking right before bedtime? This is the first thing I'd do...if your bedtime numbers are down around 80-90, you might be experiencing lows overnight, which means you'd need a small bedtime snack.

But, if your bedtime numbers are not too low, it's possible that you are having Dawn Phenomenon. The only way to test this, unfortunately, is to wake up several times at 3:00 AM, 4:00 AM and possible 4:30-5:00 AM and test. If your numbers at those times are reasonably normal, but not too low (not below 70), then it is Dawn Phenomenon. In that case, it's possible that some NPH insulin at bedtime, which peaks about 4-6 hours after you take it, could lower those morning numbers or, you could take a unit or two of rapid-acting insulin upon awakening. On the other hand, if you test at those hours and your numbers are below 70, then possibly you might actually need a bedtime snack.

I'm going through the same thing myself...all of a sudden, for the past several weeks, my morning numbers have been getting higher and higher. Unfortunately, I take sleep medication, so getting up to test in the wee hours hasn't been successful yet...but I will keep trying. I'm pretty certain it's Dawn Phenom, but then I did have one morning when I woke up at 95...just to confuse the issue, I guess!

Ruth
thanks Ruth

Every now and then I test if I wake up around 2 or 3 or 4am to visit the washroom. I am never low, usually 100ish. So I am sure it's dawn phenomenen. I get the rise with the peak at around 7AM

I have tried every combination of snack before/type of snack/excercise before bedtime......nothing helps or hurts.

It's more random, but for several days in a row. I will be 100 one week, 110 the next, 120 the next, back to 110, usually for at least a week. I don't see 100 one day, 120 the next....

I had one bought of really bad few weeks, where I was getting 140s. I also had 1/3 of my body covered in poison ivy. Sure enough things came back to normal when the poison ivy went away.

I ended up seeing the doc. He says I shouldn't muck with my "circadian rhythm". He said no to the insulin. My 1ac is good enough he says. "just continue doing what you're doing", which is ok, I guess.

He talked a little about Januvia. He said it would help prevent absoption of glucose while eating. I can do the same with carb counting and low GI so I said no thanks. It would do little for my fasting.

Apparently a bit of wine at night helps morning fasting levels. I like this theory and am sticking to it :-)

He had never heard of the GAD antibody test, so I guess I will continue to experiment on my own. If I would have asked to see an Endo he probably would have got very miffed.

what kind of sleep medication are you taking ? Maybe that has something to do with it. I took some Melatonin at one point and it made my numbers go coocoo.

Last edited by itotito; 09-26-2008 at 01:51 PM.

 
Old 09-26-2008, 07:02 PM   #4
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Re: Question for insulin users

Sounds like great numbers but I realize that any amount of better is the best! I would just give yourself a break and allow for numbers in that range unless your doc is concerned. Your long acting basal could be adjusted by 1 or 2 units and that might take care of it. I dont know if I would be switching to NPH which is extremely variable because you may make things horrible where you are doing so well! Most people would pay big money to have such tight control! Congrats!

 
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